Ventilation

Personalized ventilation provides unique patient insight and ventilation capabilities. It consists of a diagnostic tool that helps you monitor diaphragm activity (Edi) on the ventilator screen and a ventilation mode (NAVA®) that uses the diaphragm activity to deliver assist adapted to the patient.

How to see and deliver what your patient wants

In most intensive care units 20% of patients consume 80% of ventilation resources, which may lead to increased complications and unwanted outcomes.1 For these patients conventional ventilation simply isn’t enough. With personalized ventilation, the ventilator shows you what the patient wants, which may help you wean earlier with increased comfort, decreased sedation and reduced complications.

1. Identify common ventilator challenges

Only 10% of experienced clinicians detect auto-triggering, one of many challenges that can result in patient-ventilator agitation, increased sedation and delayed weaning. This is because the ventilator waveforms show you what the ventilator delivers, not what the patient wants.2

Seeing patient diaphragm activity on screen (Edi) helps you:

monitor and safeguard the patient’s diaphragm activity3,4

assess effort and work of breathing during weaning5

prevent muscular exhaustion during weaning trials, even after extubation.6

2. Keep the diaphragm active

Edi helps you detect diaphragm activity early and Neurally Adjusted Ventilatory Assist (NAVA) helps you exercise the diaphragm on a personalized level.7,8

3. Protect the lung from injury and wean earlier

An active diaphragm is the first step towards successful weaning. The second step is to avoid lung injury. NAVA delivers assist in proportion to and in synchrony with the patient’s respiratory efforts, which can contribute to:

How personalized ventilation works

During normal respiration, a spontaneous breath begins with an impulse generated by the respiratory centers in the brain. This impulse is then transmitted via phrenic nerves and electrically activates the diaphragm, leading to a muscle contraction. The diaphragm contracts into the abdominal cavity, which leads to a descending movement, creating a negative alveolar pressure and an inflow of air.

The signal that excites the diaphragm is proportional to the integrated output of the respiratory center in the brain and controls the depth and cycling of the breath.

With personalized ventilation the electrical discharge of the diaphragm is captured by a special catheter fitted with an array of electrodes (the Edi catheter) and visualized on the ventilator screen. This is Edi, the electrical activity of the diaphragm. The Edi catheter is placed in the esophagus much like an ordinary feeding tube. With NAVA, Neurally Adjusted Ventilatory Assist, the Edi is used to deliver ventilation in time with and in proportion to the diaphragm activity.

The benefits of Edi monitoring

The diaphragm is the “heart” of the respiratory system and is designed to be continuously active.1 The Edi is a bedside diagnostic tool that allows you to monitor and safeguard the patients diaphragm activity.2,3 The Edi guides weaning4 and helps you prevent muscular exhaustion during weaning trials, even after extubation.5

How to detect an inactive diaphragm

Below notice how the pressure curve (yellow) to the middle and to the right seems just fine, even though the diaphragm as demonstrated by the Edi signal (pink) is inactive compared to the image on the left where the pressure curve follows the shape of the Edi signal.

Active diaphragm(NAVA ventilation)

Over-sedation(Pressure support)

Over-assist(Pressure support)

How to detect patient ventilator-asynchrony

Identifying any of the many asynchronies is just as easy. Below are a few examples of asynchronies visible directly on the screen, continuously.

The benefits of NAVA ventilation

NAVA1 follows the Edi, and allows the patient to select the tidal volume and respiratory pattern. As such NAVA® promotes lung protective spontaneous breathing2,3,4 with higher diaphragmatic efficiency,5,6 and fewer periods of over and under-assist.7,8 The patient’s ICU experience can be improved by reduced sedation, higher comfort scores9,10,11 and improved sleep quality.12,13 NAVA simply delivers what the patient wants.

For all patient groups

Edi and NAVA assure that breathing efforts from all patient categories are effectively assessed and responded to. NIV NAVA is also independent of leakage in patient interfaces and may prevent respiratory failure and intubation.14,15,16

Getinge Group is a leading global provider of products and systems that contribute to quality enhancement and cost efficiency within healthcare and life sciences. We operate under the three brands of ArjoHuntleigh, Getinge and Maquet. ArjoHuntleigh focuses on patient mobility and wound management solutions. Getinge provides solutions for infection control within healthcare and contamination prevention within life sciences. Maquet specializes in solutions, therapies and products for surgical interventions, interventional cardiology and intensive care.